chest pain

I am a 65-year-old man. Recently I was admitted to a hospital after having chest pain. The doctor thought I had ischaemia, or reduced blood supply to the heart, and advised me a test called coronary angiography. Will I have to undergo a bypass surgery?

No, just going for the test does not indicate you need a surgery. Results of the angiography will help doctors decide whether you need a bypass. Instead of the surgery, you may need a coronary angioplasty ? a non-surgical procedure to open up the blocked arteries with the help of a catheter and a balloon. The report may as well suggest that the blocks in your coronary arteries are not serious enough to warrant any of the procedures. In that case I think medicines will be the right treatment for you.

pacemaker care

I am a 70-year-old man suffering from a heart block. A pacemaker was implanted to correct it. I have been trying to lead a restricted life. What are the specific precautions I should take?

It is a misconception that people with pacemakers have to live an austere life. Just remember the following points. If you are a mobile phone-user, don’t hold it to the ear which is close to the pacemaker (it is usually implanted below the collar bone on the left side, but in some cases it may be on the right). Do not carry it in your breast pocket next to the pacemaker. However, microwave ovens and other domestic appliances do not pose any danger, provided they are properly earthed. Do not lean on or linger near electrical surveillance systems installed at certain shop entrances. While using electrical tools, such as electric drills, it is wise to keep it at least six inches’ distance from the pacemaker. However, it is important to stay away from arc welders, transmitters of television or radar, high-power and high-voltage equipment. MRI scans should also be avoided. If you are hospitalised for any reason, let the doctor know that you have a pacemaker, because certain procedures need to be followed with caution. Also, try to avoid body blows on the pacemaker. Inspect the incision-spot (below which the pacemaker is implanted) regularly for any redness, swelling or discharge. In that case, you need to contact your doctor immediately.

breathlessness

I am a 45-year-old housewife. Since last year I have been feeling breathlessness whenever I go for a bit of exertion, such as climbing a couple of stairs. Is it an indication of a heart disease?

Heart disease can cause breathlessness, but there are other conditions that may cause shortness of breath. Anaemia, obesity and diseases of lungs, such as asthma or bronchitis are the other common causes of breathlessness. Shortness of breath on exertion in your case can be due to physical deconditioning. It is common in middle-aged women because of lack of exercise. Tests such as ECG, chest x-ray, echocardiography and treadmill tests may identify cardiac causes for breathlessness. A novel blood test known as BNP assay (a protein test) is useful in ascertaining whether the shortness of breath is due to a problem in the heart or in the lungs. To find out if it’s because of a lung disease lung function tests may be done.

blood pressure

I am a 37-year-old man. Last month my doctor found out that I have high blood pressure. I’m told regular exercise keeps blood pressure down. If so, can you advise me on how much exercise I need to do everyday?

Try to perform moderate-intensity activities, such as brisk walking, for 30 minutes daily. However, if you can pursue a more rigorous activity, such as jogging, just a 20-minute workout is enough. It is not essential that all the activity should be done at a stretch; it may be broken into shorter sessions throughout the day. The type of exercise is also important. Aerobic exercises such as walking, swimming, cycling etc. can keep blood pressure down. But avoid high-intensity workouts, such as those involving a bull worker, as it may cause a further rise in your blood pressure.